Transcript Dissociative Disorders - Psychopathology

Dissociative Disorders
Dissociative Disorders
Splitting off of thoughts, feelings, or
behaviors ordinarily connected
Temporary alteration in normally
integrative functions of:
Consciousness
Identity
Memory
Dissociation:
Historical Development
Psychological Development
Influence of the times
Skepticism of MHP
Controversy
Historical Development
19 the Century
Hysterical Neurosis-Dissociative type
Derived from cultural factors of time
Theatricality, puritanical ethos which
fostered repression
Mechanism of defense/neurotic
safeguard
Psychological Development
Janet: dissociation= split in consciousness
Result of of neuropsychological weakness
Freud: repression= unconscious thoughts
used to ward off painful effects
Psychological over organic explanation
Psychological Development
(cont’d)
Prince: different conscious states could
co-exist without awareness
• Freud & Prince high influence on later
researchers & theorists.
• Belief in split of conscious, not organic
etiologies
• Disappearance explained by change in
culture
Recent Trends
60’s: “me’ &“now” generation,
shift to narcissistic ethos
Skepticism (confusion of lumping)
DSM approach: diagnosis based on similarities
of sign/symptoms rather than postulation
Core concept:
Temporary disruption in memory,
identity, or consciousness
May lead to amnesia, depersonalization or
multiple personalities
Current Trends
(last 20+ years)
Resurgence of Interest: Inappropriate
diagnosis
Split in MH Profession
Existence is rare
Increase in # of
cases
Ex. I Never Promised You
a Rose Garden
Normalcy of Disassociation
Not necessarily psychopathology
Phenomena may occur spontaneously
Can be sought
Can be induced for therapeutic purposes
Society supports & reinforces to some
degree
Related to phenomenon underlying
hypnotizability
Continuous rather than singular/discrete
phenomenon
Commonplace
Dissociative Events
Daydreaming
Absorption in reverie
Examples:
Driving past one’s expressway exit
Not hearing your name called by instructor
3-yr old having imaginary playmate
“Self” accepted by public; supported in
literature & arts
Conflict, diversity, & disparity within self-structure is
central to being human
As Pathological
When complex behavior takes place
outside awareness of predominant
consciousness
Etiologies usually functional or
psychological
Can be organic
Interferes with memory, identity, or
consciousness
Etiologies
Periods of amnesia can be caused by
alcohol or substance intoxication
Head trauma
Temporal lobe epilepsy/partial
complex seizures
Synopsis of Dissociative DO
Dissociative Amnesia
One or more episodes of inability to recall personal
information.
Traumatic or stressful nature, too extensive to be
explained by ordinary forgetfulness.
Extensive memory loss, but usually doesn’t travel from
home.
Transitional, usually no treatment.
Dissociative Fugue
Sudden & unexpected (uncommon) travel from home or
work; enabling recall of past, have confusion about
personal identity, & may assume identity.
“Exit” from personality, usually temporary.
Synopsis of Dissociative DO
(cont’d)
Depersonalization Disorder
Recurrent feelings of detachment from
thoughts or body.
Reality testing remains intact
Dissociative Disorder Not Otherwise
Specified
Dissociative disoder present,
but no specific criteria met
Dissociative Identity Disorder
(DID)
Hallmark – failure to integrate identity,
memory & consciousness
2 or more distinct identities/personality
states
with relatively enduring pattern of perceiving,
relating to, & thinking a/O environment & self
Fluctuating clinical course tending toward
chronicity & recurrence
Helpful Movies & Books
Movies
Three Faces of Eve
When Rabbits Howls
Trudy Chase Story
Sybil
Books
Try to Remember
(Kotter)
The First Sin of
Ross Michael
Carlson
(Weissberg)
Sybil
When Rabbit Howls